Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $70.79 / $218.78	Professional		$44.67	$70.79	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $34.67 / $93.33	Professional	26	$25.70	$34.67	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $39.81 / $67.61	Professional	TC	$18.62	$39.81	$67.61
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $117.49	Professional		$93.33	$112.20	$117.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $48.98 / $51.29	Professional	26	$39.81	$48.98	$51.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $66.07	Professional	TC	$53.70	$63.10	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $81.28 / $107.15	Professional		$42.66	$81.28	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $37.15 / $51.29	Professional	26	$24.55	$37.15	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $39.81 / $54.95	Professional	TC	$17.78	$39.81	$54.95
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $120.23	Professional		$64.57	$93.33	$120.23
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $40.74 / $50.12	Professional	26	$28.18	$40.74	$50.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $50.12 / $69.18	Professional	TC	$34.67	$50.12	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $95.50 / $128.82	Professional		$85.11	$95.50	$128.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $40.74 / $58.88	Professional	26	$34.67	$40.74	$58.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $53.70 / $74.13	Professional	TC	$48.98	$53.70	$74.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $102.33	Professional		$56.23	$64.57	$102.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $24.55 / $44.67	Professional	26	$23.99	$24.55	$44.67
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $31.62 / $54.95	Professional	TC	$29.51	$31.62	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $66.07 / $93.33	Professional		$45.71	$66.07	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $45.71	Professional	26	$26.30	$36.31	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.92 / $45.71	Professional	TC	$17.78	$26.92	$45.71